Anxiety/Depression
Crisis Hotline Numbers
If your child is thought to have suicidal ideation, please take your child to the nearest emergency room immediately or call 911.
National Suicide Prevention Hotline: 1-800-273-8255
Trevor Project Lifeline: 1-866-488-7386
Maryland Crisis Hotline: 1-800-422-0009
South River Pediatrics realizes that diagnosing anxiety and depression in children can be difficult and early intervention is key. As many as 1 in 5 teens experience depression during adolescence, according to the AAP. We are dedicated to our patients in all aspects of life and helping navigate the pressures of today is something so crucial to today’s youth. Anxiety and Depression can look different in children in their stages of life. For instance, toddlers can develop fear or distress while away from their parents. Teens can develop depression with excess pressure from peers, school, and family stressors.
(source: CDC.gov)
In an effort to help screen our patients for depression, patients 12 years and over will fill out a PHQ-9 form at each well exam. This survey is used to detect any presence of depression and its severity, if any. We also use SCARED forms (Screen for Child Anxiety Related Disorders) to help screen for anxiety in children or adolescents.
Symptoms of Anxiety can include:
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Being afraid when away from parents or guardians
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Fearfulness about a certain thing or situation
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Being afraid of the future or about bad things possibly occurring
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Episodes of heart pounding, trouble breathing, dizziness, shaky, or sweating (Source: CDC.gov)
Symptoms of Depression can include:
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Feeling sad, hopeless, or irritable most of the time
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Not enjoying things once enjoyed
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Changes in eating or sleep patterns (eating or sleeping more than usual or vice versa)
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Feeling worthless, guilty, or useless
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Trouble paying attention
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Excessive crying or screaming
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Showing self-injury or self-destructive behavior (Source: CDC.gov)
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The first step in treatment is speaking with your child’s primary care provider about your child’s particular situation. There are various treatment options for a patient and all will be depending on your child’s particular case. Treatment for anxiety and depression can range from therapy, medication, and counseling.
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If you believe your child is suffering from depression or anxiety, or if you child has expressed symptoms of these, call our office today to speak with a provider about the best options for your child’s better health.
ADHD
Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood and can profoundly affect the academic achievement, well-being, and social interactions of children. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active. Your pediatrician will determine whether your child has attention-deficit/hyperactivity disorder (ADHD) using standard guidelines developed by the American Academy of Pediatrics. These diagnosis guidelines are specifically for children 4 to 18 years of age. It is difficult to diagnose ADHD in children younger than 4 years. This is because younger children change very rapidly. It is also more difficult to diagnose ADHD once a child becomes a teenager. There is no single test for ADHD. The process requires several steps and involves gathering a lot of information from multiple sources. You, your child, your child’s school, and other caregivers should be involved in assessing your child’s behavior. Children with ADHD show signs of inattention, hyperactivity, and/or impulsivity in specific ways.
What are some of the signs of ADHD? Many children have trouble focusing and behaving at one time or another. However, children with ADHD do not just grow out of these behaviors. The symptoms continue and can cause difficulty at school, at home, or with friends.
A child with ADHD might:
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daydream a lot
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forget or lose things
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squirm or fidget
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talk too much
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make careless mistakes or take unnecessary risks
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have a hard time resisting temptation
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have trouble taking turns
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have difficulty getting along with others
Deciding if a child has ADHD is a several step process. There is no single test to diagnose ADHD, and many other disorders, like anxiety, depression, and certain types of learning disabilities, can have similar symptoms. One step of the process involves having a medical exam, including hearing and vision tests, to rule out other problems with symptoms like ADHD. Another part of the process may include a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child.
AAP Releases Guideline on Diagnosis, Evaluation, and Treatment of ADHD
Treatment
In most cases, ADHD is best treated with a combination of behavior therapy and medication. For preschool-aged children (4-5 years of age) with ADHD, behavior therapy is recommended as the first line of treatment. No single treatment is the answer for every child and good treatment plans will include close monitoring, follow-ups and any changes needed along the way.
(Source: healthychildren.org, cdc.gov)
Behavioral/Developmental Evaluations
If your child has a developmental, learning, or behavioral problem, our providers have the training and expertise to evaluate and care for your child. Developmental-behavioral pediatricians possess training and experience to consider, in their assessments and treatments, the medical and psychosocial aspects of children’s and adolescents’ developmental and behavioral problems.
Developmental-behavioral pediatricians evaluate, counsel, and provide treatment for children, adolescents, and their families with a wide range of developmental and behavioral difficulties, including:
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Learning disorders including dyslexia, writing difficulties, math disorders, and other school-related learning problems
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Attention and behavioral disorders including attention-deficit/hyperactivity disorder and associated conditions including oppositional-defiant behavior, conduct problems, depression, and anxiety disorders
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Tics, Tourette syndrome, and other habit disorders
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Regulatory disorders including sleep disorders, feeding problems, discipline difficulties, complicated toilet-training issues, enuresis (bedwetting), and encopresis (soiling)
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Developmental disabilities including cerebral palsy, spina bifi da, mental retardation, autism spectrum disorders, and visual and hearing impairments
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Delayed development in speech, language, motor skills, and thinking ability
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Behavioral and developmental problems complicating the full range of pediatric chronic illnesses and disabling conditions (for example, genetic disorders, epilepsy, prematurity, diabetes, asthma, cancer)
(Source: healthychildren.org)
Birth Control
Our Providers are able to do initial and follow up consultations to provide several Birth Control options to our patients. We offer the Depo vaccine and oral contraceptives. Our providers will do an in office consultation to discuss the pros and cons of each option and help decided which would be the safest and most effective for the patients needs. We can also help in referring the patient to an GYN specialist if necessary. Below is a useful site to help navigate options for Birth Control.
Nutritional Counseling
If you have any concerns regarding your child and their nutrition, our providers can help! We can provide counseling regarding the importance of good nutrition and how it can impact your child’s health. We can help with picky eating, feeding difficulties, poor growth, and other nutritional concerns! If you have any concerns or questions regarding your child’s health and nutrition, please call our office to schedule an appointment with one of our providers
Allergy and Asthma
The air we breathe is filled with pollen, pollutants, and dust. Most children and adults are unaffected by these intruders. For a large number of children, however, these simple contaminants can make life miserable.
Asthma
One of the surprising facts about asthma is that it is such a common disease. More than 23 million Americans have the condition and more than one-quarter of them are children younger than 18 years. The rates are steadily rising, though no one can state exactly why. There are probably many reasons for the increase. Not only are we learning more about what causes asthma, but we also have more accurate methods of diagnosing the disorder and better ways to treat it, even in very young children.
Asthma may appear at any age; however, between 80% and 90% of children with asthma develop symptoms by age 4 or 5 years. Fortunately, in the vast majority of cases, symptoms are mild to moderately severe. When the condition is properly managed with medications and environmental measures, most severe, potentially incapacitating flare-ups can be prevented. There are often early warning signs that a child is at risk for developing asthma— eczema starting in the early months, frequent lower respiratory symptoms and problems appearing before the first birthday, and having a family history of asthma.
Recognizing Asthma
Many children suffer needlessly because those around them aren’t aware of the warning signs of asthma and do not bring the signs to their pediatricians’ attention. Asthma can masquerade for years as chronic or recurrent bronchitis, recurrent pneumonia, chronic cough, or lower respiratory infections. Discuss with your pediatrician the possibility that your child has asthma if he has these masquerading conditions. Also call your pediatrician for an appointment if your child
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Wheezes
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Coughs regularly, especially at night or with exertion
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Has a tight feeling in the chest
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Is often short of breath
Symptoms may not always be there; instead, they may occur occasionally, such as when your child plays energetically, laughs or cries, or sleeps. Perhaps you notice that your child wheezes or coughs when visiting a home in which someone smokes or has a cat. If symptoms come on at particular times, be sure to mention the circumstances to your pediatrician. The more facts your pediatrician has, the easier it is to diagnose asthma and the sooner treatment can start. (Source: healthychildren.org)
Allergies
A child who sneezes or coughs a lot, who frequently develops a rash or hives, or who gets a stomachache, cramps or nausea after eating certain foods may have allergies. Any child may develop allergies, but they are more common in children from families with a history of such reactions.
Early identification of childhood allergies will improve your child’s quality of life, reduce the number of missed school days and help you avoid having to use sick time or vacation days to care for your child.
Your pediatrician will ask whether your child’s symptoms often appear during a particular season of the year, at a certain location, or when your child is around animals, such as cats. Your pediatrician will also ask whether symptoms come on after your child has eaten a particular food.
Your pediatrician will ask whether other members of the family have hay fever, asthma, or eczema because allergy and asthma run in families. However, even if you can’t recall a single relative who sneezes and wheezes, your doctor will not discount allergy and asthma in your child because, like many disorders, they can appear with no prior family history. (Source: healthychildren.org)
American Academy of Pediatrics: Allergy Tips
Seasonal Allergies: Nip Them in the Bed
Food Allergies in Children
Kids Health: Seasonal Allergies (Hay Fever)
Common Allergens
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Outdoors: tree pollen, plant pollen, insect bites or stings
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Indoors: pet or animal hair or fur, dust mites, mold
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Irritants: cigarette smoke, perfume, car exhaust
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Foods: peanuts, eggs, milk, and milk products
(Source: American College of Allergy, Asthma and Immunology)
Breathing treatments help a patient breathe better by treating wheezing, shortness of breath, and other respiratory problems. Breathing treatments involve inhaling medications in a mist form using a nebulizer device. Your child's provider may recommend breathing treatments as they see fit to treat asthma, pneumonia, among other conditions.